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Submission to the Change NHS consultation

Post date: 08/11/2024 | Time to read article: 7 mins

The information within this article was correct at the time of publishing. Last updated 08/11/2024

Overview of the consultation

Between October and December 2024, the Government opened a consultation titled 'Change NHS' to invite the public to share their views to inform their development of a 10 Year Health Plan for England. More information can be found on the dedicated consultation page

Consultation 

Q1. What does your organisation want to see included in the 10-Year Health Plan and why?

Dentistry in the UK is at a crossroads. The new Government has an opportunity to prioritise long overdue reforms that would significantly improve the experiences and outcomes of dentalcare professionals and their patients.

Important decisions - ranging from changes to the NHS General Dental Services Contract to regulatory reform – have been deferred and delayed must now be addressed. The start of a new Parliament – and the commitment to introducing a 10-year plan – provides the opportunity to implement a broad range of changes to secure, strengthen and safeguard dental services fit for the future.

For dentistry, Dental Protection’s recommendations for the 10-Year Health Plan cover four areas.

Access to dentistry. The number of adults able to see an NHS dentist has dropped significantly since the pandemic, disproportionately affecting certain regions, especially rural and deprived areas. This creates a disparity that compounds over time, and it deepens inequalities within society, affecting marginalised, vulnerable communities disproportionately. With some patients reportedly resorting to self-treatment, access to NHS dentistry should be a high priority would improve dental outcomes and patient satisfaction, whilst reducing incidents of complaints.

On a societal level, the prevalence of self-treatment suggests a gap between the public health ideals in the UK and actual service provision. This raises ethical concerns from a distributive justice perspective; in a country that aspires to provide a state health service based on need, the Government has a moral obligation to ensure that dental services are available and that this is recognised as a basic right rather than a privilege.

Improving child oral health. One in four 5-year-olds in England have visible tooth decay and in the 2022-23 financial year, over 31,000 children were admitted to hospitals for tooth extractions. These are preventable conditions and cost the NHS over £64.3 million. In a developed country, this high rate of preventable hospital admissions is unacceptable.

Grow, support and retain the dental workforce. Although there are welcome plans to expand dental training places, retention remains a challenge, and many dental professionals consider leaving due to stress, burnout, and mental health concerns. A comprehensive workforce retention strategy that prioritises wellbeing is essential to prevent further workforce loss. The increasing dependence on overseas-trained professionals also required attention. It is important that the Government work with the NHS to ensure that these professionals are not seen as ‘plugging gaps’ in the system; they must be viewed as part of the team, with an acknowledgement that they need the necessary support, induction, supervision and development to thrive.

Regulatory and tort reform. The Dentists Act which sets out the powers of the GDC turned 40 years old in July 2024. Itis out of date and adds unnecessary burden to how the GDC should conduct its operations. In December 2023, the previous government confirmed its commitment to introducing reforms that would benefit the General Medical Council, Nursing and Midwifery Council and Health and Care Professions Council - with no commitment or even any reference to when GDC reform might progress. It is time for GDC reform to be placed at the front of the queue. In a similar vein, it is important that a balance is struck between appropriate compensation for patients harmed following clinical negligence and ensuring the costs of claims are affordable. We urge the government to bring forward a strategy that sets out a package of legal reforms to tackle the rising costs of clinical negligence - and in particular to ensure that the impact of claims on dentistry is central to considerations.

We expand on each of these points in Q5, providing particular policy ideas and immediate priorities.

Improvements in each of these areas would strengthen NHS dental services, benefiting dentists, other dental professionals, and their patients alike. By addressing these issues, the government can create an NHS where dental professionals are supported, allowing them to deliver safer, more compassionate patient care.

Earlier this year Dental Protection released a policy document outlining our priorities for the next Government ahead of the General Election. Our full document, including more detailed explanations of specific policy changes, can be found here: ‘Priorities for the next Government’

Q2. What does your organisation see as the biggest challenges and enablers to move more care from hospitals to communities?

Treating more patients in the community, where possible, is a positive step. However, as a defence organisation, we are not best placed to advise on policy change and proposals linked to increasing community care. We defer to other organisations with more evidenced insight and comments on these issues.

Q3. What does your organisation see as the biggest challenges and enablers to making better use of technology in health and care?

Dental Protection believes in principle that technology should be better utilised in dental settings to support effective service delivery, facilitate remote consultations and enable preventive messages to patients. The biggest challenge is to align this vision with the contract reform agenda to ensure that there is integration of services.

Q4. What does your organisation see as the biggest challenges and enablers to spotting illnesses earlier and tackling the causes of ill health?

Early diagnoses and the prevention of poor oral health must be central to improving the oral health of the population and reducing the burden on NHS dental services.

We believe that NHS contract reform and a review of the scope of practice for each registrant group could enable the skills mix within the dental team to be utilised more fully. With changes to the scope of practice for groups to carry out screening, we could better identify children most at risk of developing dental disease, with those most at risk getting an intervention from another member of the team. In addition, increasing public health funding would enable councils to offer early interventions and break the cycle of delayed care.

While we would defer to other organisations with more of a role to play in clinical matters, we would be happy to contribute to discussions about how such reforms could be implemented.

Q5. Please use this box to share specific policy ideas for change. Please include how you would prioritise these and what timeframe you would expect to see this delivered in, for example: Quick to do, that is in the next year or so, in the middle, that is in the next 2 to 5 years, long term change, that will take more than 5 years.

MPS believes that to build an NHS fit for the future, the following dental reforms must be prioritised and addressed without delay. Across each of these areas – access to dentistry, child oral health, workforce and reforms – there are critical policy changes that will contribute to services where dentists can continue to deliver safe, compassionate care whilst also being appropriately supported.

Access to NHS dentistry may be improved through:

Contract reform – make immediate commitments to deliver a ‘new’ contract within this parliament to enable dental care professionals to work in different ways and to make the best use of the skill mix within the profession.

Retaining, training and support – publish and implement a strategy to retain the current dental workforce while increasing the number in training. Support those coming to work in the UK through support, induction, supervision and development. is essential. Encourage and incentivise both UK and overseas trained dental professionals to work in high need areas and so-called dental deserts.

Adoption of technology to facilitate remote consultations

Child oral health should be prioritised through:

Funding – increase public health funding in order for councils to offer early interventions, breaking the vicious cycle of delayed care.

Review of the scope for each registrant group – make changes to the scope of practice so that each registrant group can carry out screening which would better identify children most of risk of developing dental disease.

The dental workforce should grow and be supported by:

Training and retaining the dental workforce immediately work with the NHS to develop a dental workforce retention strategy which at the core is centred on the wellbeing of dental professionals.

Supporting overseas qualified professionals – ensure overseas trained dentists have adequate access to support, inductions, supervision and development in order to thrive.

Enabling dental professionals to work in different ways – commit to GDS contract reform and a review of the scope of practise for each registrant group.

Focus on regulation and claims reform to ensure dentistry is no longer at the back of the queue through:

General Dental Council reform without delay, rollout reforms to The Dentists Act, to enable the GDC to better streamline processes to improve efficiency and reduce the number of investigations into less serious allegations.

Tort reform - bring forward a strategy that sets out a package of legal reforms to tackle the rising cost of clinical negligence to be implemented within the course of this Parliament, and with a specific focus on reducing the cost of claims in dentistry. Increase the Fixed Recoverable Costs (FRC) scheme to cover cases up to £50,000 and review the effectiveness of the existing FRC scheme 12 months’ post implementation with specific reference to whether the same is effective in tackling the overall cost of dental claims.

As previously stated, in July 2024 Dental Protection released a policy document outlining our priorities for the next Government ahead of the General Election. Our full document, including more detailed explanations of specific policy changes discussed in our response, can be found here: ‘Priorities for the next Government’.

About Dental Protection

Dental Protection is part of the Medical Protection Society (MPS), the world’s leading protection organisation for doctors, dentists, and healthcare professionals. MPS protects and supports the professional interests of more than 300,000 members around the world and is proud to have supported over 30,000 dentists and dental care professionals in the UK for many years.

Membership provides access to expert advice and support together with the right to request indemnity for complaints, investigations or claims arising from professional practice.

We are a mutual non-for-profit organisation and the benefits of membership of MPS are discretionary as set out in the Memorandum of Articles of Association. MPS is not an insurance company. 

About MPS

MPS is the world’s leading protection organisation for doctors, dentists and healthcare professionals with almost 300,000 members around the world.

Our in-house experts assist with the wide range of legal and ethical problems that arise from professional practice. This can include clinical negligence claims, complaints, medical and dental council inquiries, legal and ethical dilemmas, disciplinary procedures, inquests and fatal accident inquiries.

MPS is not an insurance company. We are a mutual non-for-profit organisation and the benefits of membership of MPS are discretionary as set out in the Memorandum of Articles of Association.

Contact

Should you require further information about any aspects of our response to this consultation, please do not hesitate to contact us.

Ceylan Simsek
Policy and Public Affairs Officer
[email protected]

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